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SAN <br /> J Hl O + Q U I ` ,'�IVI Environmental Health Department <br /> 4 <br /> Food Program Official Inspection Report <br /> Facility Name and Address: Save Mart#781, 875 S Tracy Blvd,TRACY 95376 <br /> #33 Nonfood Contact Surfaces Clean <br /> OBSERVATIONS:Some of the shelving in the dairy walk-in has some mildew accumulation. Clean and sanitize the <br /> shelving by 2 weeks. <br /> CALCODE DESCRIPTION:All nonfood contact surfaces of utensils and equipment shall be clean. (114115(c)) <br /> #35 Equipment/Utensils Approved and in Good Repair <br /> OBSERVATIONS:One of the ice scoops at the meat/seafood department is in disrepair. Discontinue use of this ice scoop <br /> today. <br /> CALCODE DESCRIPTION:All utensils and equipment shall be fully operative and in good repair. (114175).All utensils and equipment <br /> shall be approved,installed properly,and meet applicable standards. (114130, 114130.1, 114130.2, 114130.3, 114130.4, 114130.5, <br /> 114132, 114133, 114137, 114139, 114153, 114155, 114163, 114165, 114167, 114169, 114172, 114177, 114180, 114182) <br /> #41 Plumbing Maintained;Approved Back Flow Device <br /> OBSERVATIONS:The hand sink at the deli (by oven)leaks at the drain pipe. Repair to proper by 1 week. <br /> The back flow prevention device at the mop sink leaks. Repair to proper by 1 week. <br /> CALCODE DESCRIPTION: The potable water supply shall be protected with a backflow or back siphonage protection device,as required <br /> by applicable plumbing codes. (114192)All plumbing and plumbing fixtures shall be installed in compliance with local plumbing <br /> ordinances, shall be maintained so as to prevent any contamination,and shall be kept clean,fully operative,and in good repair. Any hose <br /> used for conveying potable water shall be of approved materials,labeled,properly stored,and used for no other purpose. (114171, <br /> 114189.1, 114190, 114193, 114193.1, 114199, 114201, 114269) <br /> OVERALL INSPECTION NOTES AND COMMENTS <br /> OBSERVATIONS <br /> Name on Food Safety Certificate: needed Expiration Date: <br /> Warewash Chlorine(Cl): ppm Heat: °F Water/Hot Water Ware Sink Temp: 120°F <br /> Quaternary Ammonia(QA): 200 ppm Hand Sink Temp: 100°F <br /> FOOD ITEM--LOCATION--TEMP°F--COMMENTS <br /> FA0007582 PR0507849 SCO01 06/10/2020 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 3 Food Program OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />